title: Outcome and prognostic factors of patients with acute leukemia admitted to the intensive care unit for septic shock.
abstract: The purpose of the present study was to evaluate outcomes and identify prognostic factors in patients with acute leukemia who were admitted to the intensive care unit (ICU) with septic shock. Medical records of 50 patients with acute leukemia who were treated for septic shock in the Medical ICU of Samsung Medical Centre between September 2001 and June 2006 were retrospectively reviewed. The data were analysed for patient outcomes and for predictors of ICU mortality. ICU mortality and in-hospital mortality were 60% and 68%, respectively. The need for mechanical ventilation (p<0.001), the addition of norepinephrine to dopamine (p<0.001) and a poor Sequential Organ Failure Assessment (SOFA) score (p<0.001) were associated with ICU mortality in the univariate analysis. In the multivariate analysis using the Cox-model, a relapsed/refractory status for leukemia and poor SOFA score were independent predictors for ICU mortality. In conclusion, although the mortality was high in patients with acute leukemia who were admitted to the ICU for septic shock management, it was not high enough to preclude intensive care. Patients with severe organ failure and a relapse/refractory status for leukemia had a significantly worse prognosis.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Eunhae
authors.initials: E
authors.lastname: Kang
authors.forename: Min-Ji
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000328:Adult; D004298:Dopamine; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D009638:Norepinephrine; D011379:Prognosis; D012008:Recurrence; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*
chemical_list: D004298:Dopamine; D009638:Norepinephrine